Strategic Research andInnovation Agenda
European Partnership on One Health Antimicrobial Resistance

OHAMR Secretariat
Swedish Research Council
Box 1035
SE-101 38 Stockholm
OHAMR Strategic Research and Innovation Agenda

www.ohamr.eu
ohamr@vr.se+46 8 546 44 000
1.

The current SRIA has been developed by the Coordination and Support Action (CSA) DESIGNOH AMR, funded by the European Commission (Grant agreement ID: 101057036), in close
collaboration with the JPIAMR Scientific Advisory Board and other experts, the JPIAMR member
states and the European Partnership on One Health Antimicrobial Resistance partners (OHAMR).
More information on the SRIA development process can be found in Annex 1.

Photo credits
Cover: Cattle, Despositphotos, picture id 21794891; Petri dish with bacteria growth, Depositphotos,
picture id 119389888; People crossing the street, Depositphotos, picture id 232488234.
Page 6. Professor Alexander Fleming. Ministry of Information Photo Division Photographer, Public domain, via Wikimedia Commons.
Page 7. Petri dish with bacteria growth. Unsplash, Michael Schiffer.
Page 11. Hospital ward. Depositphotos, picture id 11479074.
Page 15. Rapid diagnostics self-test kit. Depositphotos, picture id 699722208.
Page 19. Tulip field, the Netherlands. Depostiphotos, picture id 143977519.
Page 23. Poultry farm. Depositphotos, picture id 211251150.
Page 30. Drive-thru pharmacy, USA. Depositphotos, picture id 2654412.
Page 40. Boat on the Yamuna river. Despositphotos, picture id 86905392.

OHAMR Strategic Research and Innovation Agenda

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Contents
Executive summary  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Antimicrobial Resistance: one of the top 10 threats for human health  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Research and innovation: a pivotal instrument to prevent antimicrobial resistance and mitigate its effect . . . . 12
Therapeutics  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 14
Diagnostics .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 16
Surveillance .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 17
Transmission and Evolution .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 18
Interventions for prevention and mitigation  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 20
A European Partnership on One Health AMR to support AMR Research and Innovation . . . . . . . . . . . . . . . . . . . 21
The OHAMR: Vision, Mission, and Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Vision  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 24
Mission .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 24
Values .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 24
Focus areas of the OHAMR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Focus Area 1: Prevent emergence and spread of AMR .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 29
Focus area 2: Strengthen appropriate use of antimicrobials and infection prevention and control  .  .  .  .  .  .  .  .  .  . 31
Focus area 3: Provide innovative and cost-effective treatment options .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 31
Programmes and actions of the OHAMR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
R&I Funding Programme  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 34
Capacity Strengthening Programme .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 35
Data Exploitation Programme .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 36
Impact Programme for knowledge mobilization .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 38
Monitoring of the progress of the OHAMR towards its objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
OHAMR General objectives and their key performance indicators .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 44
OHAMR Specific objectives and their key performance indicators .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 45
Operational objectives and their key performance indicators  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 46
The OHAMR pathway to impact  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 51
Synergies and Collaborations with other Partnerships, initiatives and Stakeholders . . . . . . . . . . . . . . . . . . . . . . . 54
Annex 1. SRIA development process and plans for update  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Development Process .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 60
SRIA Update .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 62
Annex 2. Detailed list of topics and subtopics covered by the three focus areas . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Focus Area 1: Prevent emergence and spread of AMR .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 63
Focus area 2: Strengthen appropriate use of antimicrobials and infection prevention and control  .  .  .  .  .  .  .  .  .  . 64
Focus area 3: Provide innovative and cost-effective treatment options .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 65
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

OHAMR Strategic Research and Innovation Agenda

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Executive summary
Antimicrobial resistance (AMR) is a global health challenge that affects human and animal health,food security and the environment. The World Health Organization (WHO) has recognised AMR
to be one of the top 10 global public health threats facing humanity1. The European Commission(EC) has also identified AMR as one of the top three priority health threats2. Immediate action
is needed to boost AMR research and innovation (R&I) to better understand the biologicalmechanisms of resistance and evolution in microorganisms, as well as transmission routes anddrivers, including social human factors. R&I is also needed to develop new treatments and rapid
and affordable diagnostics, improve current treatment solutions, improve surveillance methods
and design innovative AMR preventing and mitigating interventions.
The European partnership on One Health AMR (the OHAMR) is one of the key European
partnerships that has been identified by the EC within the framework of the Horizon Europe
programme3 to support R&I to respond to the challenges of AMR. By deploying a joint research
programme, co-funded by the OHAMR partners and the EC, the OHAMR will contribute to theobjectives of the European Union (EU) One Health Action Plan against Antimicrobial Resistance4,
to the European Parliament resolution on EU action to combat antimicrobial resistance5 and to
the Council Recommendation on Stepping up EU actions to combat antimicrobial resistance ina One Health approach6. The OHAMR aims to align and coordinate strategic AMR R&I policies
by attracting partners from EU and beyond, providing jointly support to R&I and mobilisingknowledge in the fight against AMR. It will deploy an integrated One Health approach, recognisingthat human, animal and plant health are interdependent and interlinked with the environment.
The OHAMR builds the work of the Joint Programming Initiative on AMR (JPIAMR), but aims at abigger ambition, as well as a stronger integration of social sciences and humanities, support ofinnovation, and international engagement. Through this approach, the OHAMR will contribute to
reduce the existing fragmentation of the R&I landscape, thus enabling the different One Healthsectors and scientific disciplines to tackle the complex challenge of AMR with joint forces. The
OHAMR will engage with different national and international stakeholders to seek synergy andavoid duplication of efforts.

1

WHO (2019): Ten threats to global health in 20192

Health Emergency Preparedness and Response Authority (2022): HERA factsheet- HEALTH UNION: Identifying top 3 priority health threats

3

Horizon Europe Work Programme 2023-2024, Health4

EU One Health Action Plan against AMR (2017)

5

Resolution on EU action to combat antimicrobial resistance (1 June 2023)

6

Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach (13 June 2023)

OHAMR Strategic Research and Innovation Agenda

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The European Partnership on One Health Antimicrobial Resistance (OHAMR) will contribute to theobjectives of the EU Action Plan on antimicrobial resistance (AMR), to combat the critical societal
challenge of AMR and reduce the burden of AMR by:•••

Enhancing European and global synergy, multi-sectoral and multidisciplinary
collaboration, and alignment of strategic OH AMR R&I and policies to break silos;
Boosting AMR research & innovation to generate knowledge and develop solutions
to prevent and tackle AMR;
Facilitating knowledge valorisation of research and innovation into products, policy
and practice.

The OHAMR is structured around three focus areas which will be executed through four
programmes. The three focus areas encompass: (i) prevent the emergence and spread of AMR,(ii) strengthen appropriate use of antimicrobials and infection prevention and control and (iii)
provide innovative and cost-effective treatment options. Each of the three focus areas covers
various aspects relative to therapeutics, diagnostics, surveillance, transmission& evolution, andinterventions.
To ensure its mission, the OHAMR will deploy a wide range of activities organized under four
programmes: (i) the R&I Funding programme, to provide a financial support to AMR R&I; (ii) the
Capacity Strengthening Programme, to support training, networking and collaboration acrossdisciplines, sectors, countries and career stages; (iii) the Data Exploitation Programme, to facilitate
and promote access, sharing and (re) use of data and research infrastructures; and (iii) the Impact
Programme for knowledge mobilization, to facilitate uptake of research results into products,
practice and policy for maximum societal impact.
The current Strategic Research and Innovation Agenda (SRIA) presents the vision, mission,
objectives, scientific focus, and implementation plan of the OHAMR, and serves as the strategic
foundation of the partnership to guide its future actions. The OHAMR SRIA is the outcome of theefforts of the scientific community, member countries as well a broad range of stakeholders who
contributed through numerous consultations organised by the Coordination and Support Action(CSA) DESIGN OH AMR7, funded by the EC. This SRIA has been drafted in close collaboration with
the WHO and the quadripartite organisations8 to ensure an alignment with their respective AMR
agendas9,10. An update of the SRIA is expected three years after the launch the partnership.

7

European Commission: DESIGNing the European Partnership on One Health AMR

The Quadripartite organisations: the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme(UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH)
8

9WHO Global research agenda for antimicrobial resistance in human health (2023)

10

Quadripartite A one health priority research agenda for antimicrobial resistance (2023)

OHAMR Strategic Research and Innovation Agenda

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Antimicrobial Resistance: one of
the top 10 threats for human healthAlexander Fleming published his first article describing the effect of penicillin in 1929 in the British
Journal of Experimental Pathology. Since then, many other antimicrobials including, antibiotics,
antifungal, antiviral and antiparasitic agents have been developed. Antimicrobials have saved
millions of lives, including previously common deaths associated with childbirth, routine surgeries
and minor wounds. Modern medicine is reliant on antimicrobials to prevent infections that canoccur in immunosuppressed patients undergoing organ transplant or cancer treatment.

“With doses too small, the microbes will not be killed, andthere is a danger that they will be educated to resist penicillin.
There are few simple rules for penicillin treatment:• First, use it only on a suitable microbe• Second, use it in such a way that it gets into contact with themicrobe.
• Third, use it in sufficient dose
• Fourth, keep the treatment long enough to kill them all”
Sir Alexander Fleming, BBC recording for Science Notebook, 28 August, 1945

Unfortunately, as predicted early on by Alexander Fleming, microorganisms have the capacity toadapt and develop resistance to antimicrobials through genetic modifications (gene mutations
or gene transfer). The extensive (and often improper) use of antimicrobials (in medicine, but also
in agriculture to prevent infectious diseases in livestock, crops and horticulture) contributes toincreasing the selection of resistant microorganisms to alarming levels. Modern medicine is now
running out of therapeutic options, and there is a huge risk to revert to the pre-antimicrobial era
where even small wounds and routine surgery can be lethal. In addition, reduced antimicrobial
efficiency may result in a decline of food production11, contributing to hunger progression inpoor countries.

11

World Bank (2017); Drug-Resistant Infections: A Threat to Our Economic Future

OHAMR Strategic Research and Innovation Agenda

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Antimicrobial Resistance (AMR) occurs when bacteria, viruses,
fungi and parasites change over time and no longer respondto antimicrobial medicines (such as antibiotics), making
infections harder to treat and increasing the risk of disease
spread, severe illness and death.

OHAMR Strategic Research and Innovation Agenda

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Several studies have attempted to investigate the impact of antimicrobial resistance (AMR) by
examining its effect on health and the cost of AMR to society12,13,14. Murray et al,13 estimated that
1,27 million deaths were attributable worldwide to infections caused by bacterial AMR in 201915.
The burden of bacterial AMR is unequal and disproportionally high in Sub-Saharan Africa andSouth Asia. The burden is also alarmingly high in Europe (in particular in Eastern and Central
Europe). The burden of resistant bacterial infections in the European Union and the European
Economic Area (EU/EEA) is comparable to that of influenza, tuberculosis and HIV/AIDS combined13.
The O’Neill12 report argued that bacterial AMR could kill 10 million people per year by 2050
without any prevention and mitigation measures.
The impact of antifungal, antiparasitic, and antiviral resistance on human health is for the
moment more difficult to quantify than antibacterial resistance (with the exception of some wellcharacterised pathogens such as HIV and the different species of Plasmodium responsible formalaria). This is mainly due to the lack of robust surveillance data worldwide, and to the absenceof suitable diagnostic tests which reliably identify the aetiology of an infection. However, fungal
drug resistance is already perceived to be a major threat to public health16. In eleven years, thenumber of death attributable to fungal infections nearly doubled, passing from 2 to 3.8 million
deaths in eleven years17, with antifungal resistance as one of the possible drivers responsible forthis drastic increase. There is also growing evidence for an increasing rate in antiparasitic andantiviral resistance suggesting that these issues may be of major concern for public health in the
coming years, directly affecting human health, or indirectly, through their impact on the livestock
production.
The World Bank and the Organisation for Economic Cooperation and Development (OECD)
have reported that from 2015 to 2050 the costs of AMR will be 3.5 billion USD per year for the
expenditure on healthcare alone.18 According to the World Bank19, the economic impact of drug
resistance could be as high as a 3.8% loss of global gross domestic product worldwide, including
a 7.5% decrease in livestock output. In June 2017, OECD published estimates and calculations forthe effectiveness and the cost-effectiveness of policies to promote effective use of antimicrobials
and to prevent the spread of infections. For instance, the improvement of hand hygiene strategies
could reduce the number of hospital days by 2.45 million and number of deaths by 43%, with anestimated total saving of 2.97 billion euro per year.

12

O’Neill, J. (2014) Antimicrobial Resistance, Tackling a Crisis for the Health and Wealth of Nations.

13

Murray C.J.L et al. (2022), Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis; DOI: 10.1016/S0140-6736(21)02724-0

Cassini A.M.D (2018), Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and theEuropean Economic Area in 2015: a population-level modelling analysis; DOI: 10.1016/S1473-3099(18)30605-4

14Six pathogens (Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, andPseudomonas aeruginosa) were responsible for more than 70% of the deaths attributable to infections caused by bacterial AMR.

15

Kohlenberg A. (2022), Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021;
DOI: 10.2807/1560-7917.ES.2022.27.46.2200846

16

17David W. Denning (2024) Global incidence and mortality of severe fungal disease; DOI: 10.1016/S1473-3099(23)00692-8

18

OCDE (2018); Stemming the Superbug Tide; doi: 10.1787/9789264307599

19

World Bank (2017); Drug-Resistant Infections: A Threat to Our Economic Future

OHAMR Strategic Research and Innovation Agenda

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Climate change (mass flooding, temperature change), war (migration), pandemics, disinformation,
urbanisation (increased contact between wild-life, humans and domestic animals) and increased
exploration of the nature will also likely contribute to the spread of AMR in the coming years.
The burden of AMR on public health, thus, jeopardises achievement of several sustainable
development goals (SGDs).

AMR challenges the achievement of multiple Sustainable
Development Goals (SGDs). AMR directly impacts human health, aswell as food production, water purity and economic growth.

The World Health Organization (WHO) published its first Global Action Plan to combat AMR20
in 2015. Since then, the severity of AMR has been acknowledged in the global health agenda bya number of high-level institutions including the UN Environment Assembly, the Council of theEuropean Union21,22, the European Parliament23, the European Union24, the G725, the G2026, and the
UN General Assembly27. In 2019, the World Health Organization (WHO) declared AMR as one of
the top 10 global public health threats facing humanity28. In 2022, the European Commission and
the Member States, identified AMR as one of the top three priority health threats29.

20

World Health Organization (2015); Global Action Plan on Antimicrobial Resistance; ISBN: 9789241509763

21

Council of the EU; Press release (17 June 2016)22

Council of the EU: Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach (13 June 2023)

23

European Parliament: resolution on EU action to combat antimicrobial resistance (1 June 2023)

24

European Commission, Action Plan adopted on 29 June 201725

G7 health ministers; Communiqué (5-6 November 2017)26

G20 Health Ministers; Communiqué (19-20 May 2017)27

United Nations General Assembly, Member States, Communiqué (21 September 2016)28

WHO (2019): Ten threats to global health in 201929

Health Emergency Preparedness and Response Authority (2022): HERA factsheet- HEALTH UNION: Identifying top 3 priority health threats

OHAMR Strategic Research and Innovation Agenda

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Considering that resistant microorganisms or resistance genes are transmitted between humans,
animals (including wild-life and companion animals) and plants, often via the environment(via waste-water streams and soil30), the different UN organisations recognised that ameaningful impact on human health could only be achieved through a One Health approachthat requires a close collaboration between the different One Health sectors (human, animaland environment)31,32. The WHO joined forces with the Food and Agriculture Organisationof the United Nations (FAO), the World Organisation for Animal Health (WOAH) and the UN
Environment Programme (UNEP) to form the UN Quadripartite and to develop a One Health Joint
Plan of Action33, in which AMR is one of the action tracks. In addition, in 2017, a UN Interagency
Coordination Group on Antimicrobial Resistance (IACG)34 was set-up to coordinate the work of thedifferent UN agencies and the efforts of different sectors including animal health, agriculture andenvironment to curb AMR.

One Health is an integrated, unifying approach that aims to sustainably
balance and optimise the health of people, animals, and ecosystems.
It recognises the health of humans, domestic and wild animals, plants,
and the wider environment (including ecosystems) are closely linked
and interdependent.

Thus, there is an urgent need for a truly inter-sectoral, interdisciplinary and coordinated global
approach to generate increased knowledge and solutions to prevent and tackle AMR.

30

UNEP (2022) Environmental Dimensions of Antimicrobial Resistance

31

United Nations General Assembly, Member States, Resolution A/RES/71/3, paragraph 15 of the Political Declaration

32

Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach (2023)

FAO, UNEP, WHO, and WOAH. 2022. One Health Joint Plan of Action (2022-2026). Working together for the health of humans, animals, plants and theenvironment. Rome.
33

34
35

United Nations General Assembly, Member States, Resolution A/RES/71/3, paragraph 15 of the Political Declaration
Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis, The Lancet

OHAMR Strategic Research and Innovation Agenda

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AMR is a major threat to human health around the world. Studies haveestimated the global burden of AMR through its effect on incidence, deaths,
hospital length of stay, and health-care costs for specific pathogen–drugcombinations. The lancet report published in 2022 estimated that 4.95 million
deaths were associated with bacterial AMR in 2019, with 1.27 million deaths
directly attributable to bacterial AMR. 35

OHAMR Strategic Research and Innovation Agenda

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Research and innovation: a pivotal
instrument to prevent antimicrobial
resistance and mitigate its effectExisting tools to control and prevent AMR in human, animal and in the environment, and to treat
infectious diseases are insufficient. More research and innovation (R&I) is needed to understandthe mechanisms of resistance and evolution, as well as transmission routes and drivers, including
social factors. R&I on development of innovative solutions for new treatments, revisitedtreatment regimens, rapid and affordable diagnostics, surveillance methods and preventive andmitigating interventions are also necessary. Boosting R&I will provide more understanding on
AMR spread, and develop innovative social and technological solutions to decrease the burden of
AMR.
Research and innovation to prevent and mitigate AMR is structured under five thematic areas(figure 1):
•
•
•
•
•

Therapeutics
Diagnostics
Surveillance
Transmission and Evolution
Interventions for prevention and mitigation

The five thematic areas are complementary but not mutually exclusive meaning that some topics
are overlapping between different thematic areas.

OHAMR Strategic Research and Innovation Agenda

12.

Figure 1. The five thematic areas.
Extensive work has been conducted to identify the R&I prospects under these five thematic areas
considering the One Health dimensions of AMR, as well as the role of socio-economic factors in
the emergence and spread of AMR, the role of implementation science to facilitate the translation
and uptake of innovative solutions in real word settings, and the global challenges posed by AMR.
The following section provides a concise description of the thematic areas (a detailed information
on each of these thematic areas is provided in the long version of the Research and Innovation
Objectives available on the OHAMR webpage36).

36

Research and Innovation Objectives of the OHAMROHAMR Strategic Research and Innovation Agenda

13.

Therapeutics
Research and Innovation actions in the Therapeutics area aim to discover new therapeutictargets, develop new antimicrobial agents and therapeutic alternatives, and improveexisting antimicrobials and treatment regimens.36
Relevance of the therapeutics area for the prevention and mitigation of AMR
The number of recently approved antibiotics is inadequate and fall short of what is required tomitigate the challenge of AMR. The progressive ineffectiveness of the current antimicrobials will
inexorably lead to an immediate increase in the number of human deaths, while the possible
banning of antimicrobials to treat animal and plant infections would likely lead to a decreasein food production, and increase hunger worldwide, unless new approaches are investigatedand applied to treat infectious diseases. Hence, the development of new therapeutic solutions,
including alternatives to antimicrobials, or the improvement of current ones is urgently needed.
Research and innovation prospects in Therapeutics
R&I is needed to improve current antimicrobial therapies and enhance the discovery, preclinicaland early clinical development of novel antimicrobials, alternatives to antimicrobials andtreatment strategies. This includes the repurposing of existing drugs as well as the optimisation of
drug delivery and treatment protocols (dose, administration frequency, duration and drug
combination). In addition, R&I in this thematic area should propose solutions to accelerate theentry of novel drugs and innovative treatment protocols to the market by developing pre-clinicalmodels, by proposing innovative regulatory procedures, by developing alternative socioeconomic models to stimulate drug development, drug production and drug supply while
ensuring a high level of acceptability to end-users, appropriate use through antimicrobial
stewardship and minimal impact on the environment. Research should also assess the risk ofcross-resistance to antimicrobials used in different One Health sectors to aid development ofevidence-based policies and guidelines aimed at rationalising the use of antimicrobials in animals
and agriculture.

37

The Review on Antimicrobial Resistance: Tackling drug-resistant infections globally: final report and recommendations

OHAMR Strategic Research and Innovation Agenda

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Effective diagnostic testing plays a pivotal role in addressing AMR. Diagnostic
tests are needed to identify the pathogen responsible for the infection and the
drugs to which it is susceptible. The development and implementation of rapid
point of care diagnostics for infectious diseases could reduce time-to-result,
help select appropriate therapies, and assist in the prescription of narrowspectrum antibiotics. 37

OHAMR Strategic Research and Innovation Agenda

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Diagnostics
Research and Innovation actions in the diagnostics area aim to develop and improve
diagnostics to support the use of antimicrobials and alternatives to antimicrobials.36
Relevance of the Diagnostics area for the prevention and mitigation of AMR
Diagnostics are tools that aim to detect and characterise microorganisms (species, strain, andtheir antimicrobial susceptibility) and that can be used to guide antimicrobial prescription totreat infection or to collect data for AMR surveillance. In the absence of proper diagnostics tests,
empirical treatments are prescribed, leading to inappropriate use of antimicrobials (e.g. useof antibiotics for a viral infection), or to the prescription of less effective antimicrobials. Whendiagnostic tests are co-developed with novel antimicrobials, diagnostic tests can also facilitate theenrolment of patients during clinical trials. Tools developed for diagnostic purposes can in somecases also be used for detection of AMR in non-pathogenic microorganisms, and diagnostic data
can feed into surveillance. Thus, development of new and improved diagnostics is vital.
Research and innovation prospects in diagnostics
R&I is needed to design and develop new rapid, cost-effective and reliable diagnostic tests andmethods for identification and susceptibility testing of key pathogens, especially point of carediagnostics that can be performed on-site to guide antimicrobial prescription in both human,
veterinary medicine and agriculture. Research should also develop environmental diagnostics,
an emerging field, to assess the presence of resistant pathogens in the environment. R&I should
also contribute to improve the performance, rapidity, feasibility and cost-effectiveness of theexisting diagnostics. Since existing diagnostics are under-used by drug prescribers, researchshould identify and characterise the barriers preventing their acceptance and use. In addition,
research in social and behavioural science should also propose solutions to overcome thesebarriers. Research should also show how diagnostic tests impact clinical outcomes, AMR spreadand AMR management costs to convince local authorities to recommend the use of diagnostics.
Development of appropriate diagnostic tools is also needed to support interventions to tackle
AMR, including infection prevention and control, and antimicrobial stewardship.

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Surveillance
Research and innovation actions in the Surveillance area aim to optimise surveillancesystems and monitoring tools and methods to understand the drivers and burden of AMR
in a One Health perspective and support decision making at all levels.36
Relevance of the Surveillance area for the prevention and mitigation of AMR
Surveillance of AMR involves continuous, systematic collection, analysis, interpretation andcommunication of data to monitor and act on the level of AMR and antimicrobial use andconsumption (AMU/AMC). Surveillance is fundamental to estimate the burden of AMR, andto raise the public awareness on AMR risks. AMR surveillance will also guide the prescriptionof antimicrobials in humans, animals and crops when adequate diagnostic testing is missing.
It acts as an early-warning signal to implement targeted interventions, provide data to better
understand the transmission, directionality and risk of the spread of AMR, and produce evidence
to evaluate the effect of an intervention. For those reasons, the improvement of the current
surveillance strategies, including the optimisation, standardisation and harmonisation of thecurrent surveillance system, is fundamental.
Research and innovation prospects in Surveillance
R&I is needed to strengthen the research on surveillance systems, methods, interpretative
guidelines, and communication tools to optimise the surveillance of AMR and antimicrobial
use and consumption (AMU/AMC), using a One Health approach. In particular, researchshould identify the samples and data to be collected for an effective surveillance and develop
monitoring tools and methods. Even where substantial surveillance data are already available,
their heterogeneity, in terms of nature and quality and sustainability, constitute a real issue for
optimising their use. Research should contribute to prioritise and/or harmonise the indicators(microbial species and AMR/AMU data to collect), as well as the place and time to collect them.
Research should define standardised and harmonised sampling, analysis, interpretation andcommunication protocols, to allow comparison of the data across different One Health sectors,
including wildlife, and across different regions of the world. Surveillance data should be integrated
and analysed together with other types of data, such as meta-data, epidemiological data or social
data, for which informatic tools should be developed. Research should also propose strategies
and tools to facilitate and encourage data collection, data storage, data sharing, dissemination,communication, and the involvement of the end-users from data collection to data use. Economic
studies should demonstrate the cost-effectiveness of different strategies for surveillance, andpropose strategies/ frameworks, for quality assured AMR surveillance both in LMICs and in highincome countries. Economic or social barriers preventing the development of surveillance should
be identified, and solutions should be proposed.

OHAMR Strategic Research and Innovation Agenda17.

Transmission and Evolution
Research and innovation actions in the Transmission and evolution area aim to understandand prevent the transmission and evolution of antimicrobial resistance in a One Healthcontext.36
Relevance of the Transmission and evolution area for the prevention and mitigation of AMR
Rapid preventive actions need to be implemented to avert the threat of AMR. Such actions
include, but are not limited to, the reduction of AMR selective factors in the environment, therestriction of unnecessary AMU, and the control of human or animal exposure to contaminatedwater. Those actions are difficult to accept by the targeted end-users without strong rationale,and strong evidence of effectiveness, as they often come with an associated cost. Understanding
the mechanisms involved in the transmission and evolution of AMR will help health authorities
to design efficient preventive interventions. In addition, identifying interventions with proveneffects will encourage health authorities to adopt and scale-up the interventions. Furthermore,
a better understanding of transmission and evolution mechanisms of AMR could help to identify
new drug targets, or improve the existing drugs.
Research and innovation prospects on Transmission and Evolution
R&I is needed to improve the understanding of both the evolution and the physical transmissionof microorganisms resistant to antimicrobials within and between humans, animals and theenvironment. This includes exploring mechanisms involved in gene mobilization, transfer ofresistance, mutations, epigenetic modifications, physical transmission and maintenance ofresistance under various conditions. It also includes understanding drivers of such processes,
all the way from chemical and molecular drivers to socio-economic and behavioural ones
(including climate change and population migration), and the design of models to estimate therisk of resistance transmission. Although the massive use of antimicrobials in the medical andagricultural sectors have been shown to be associated with increased AMR in the environment,
it remains still unclear how, and to which extent, the prevalence of resistant genes in animals
and in the environment contributes to AMR risk in humans. Research should also contribute to
identify and characterise AMR reservoirs, evolutionary arenas and provide evidence behind the
directionality and scale of AMR transmission (e.g. from environment/animal to humans, but also
from non-pathogenic, such as environmental microbiota, to pathogenic strains).

3
8 Dunne, K et al. (2017), Intercountry Transfer of Triazole-Resistant Aspergillus fumigatus on Plant bulbs, Clinical Infectious
Diseases

OHAMR Strategic Research and Innovation Agenda

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Resistance totriazoles agents, the leading antifungal therapy in treating
aspergillosis caused by Aspergillus fumigatus – a fungus that causes fatal
pneumonia in immunocompromised patients, is a growing problem. The
widespread use of triazole antifungal drugs as fungicides in agriculture andfloriculture is considered to be a link connecting with this type of resistance.
Plant bulbs have been proposed to be a vehicle for international spread of thetriazole-resistant Aspergillus fumigatus. Billions of bulbs are produced every
year for a global market. 38

OHAMR Strategic Research and Innovation Agenda

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Interventions for prevention and mitigation
Research and innovation actions in the intervention area aim to develop and innovate
approaches to prevent and mitigate the emergence and spread of AMR, across One
Health.36
Relevance of the intervention area for the prevention and mitigation of AMR
AMR poses a serious threat to human health in absence of rapid actions. Hence interventions
based on new and existing evidences are needed to control and, if possible, reverse theprogression of AMR. Those interventions could be to prevent and avoid the emergence andspread of AMR before it reaches a critical threshold, as well as to mitigate when AMR has alreadyreached a significant level. Interventions would include a large variety of actions, such as the useof technological tools, the adoption of laws, regulation and protocols, the creation of economic
incentives, or structural reorganisation. On one hand, the health authorities and the national
ministries are responsible for the implementation of interventions while on the other hand theresearchers are responsible for identifying the needs and opportunities for interventions, and fordemonstrating the effectiveness of the interventions in the fight against AMR.
Research and innovation prospects in Interventions
R&I is needed to design, develop and improve approaches/tools, techniques andrecommendations for responsible antimicrobial use, prevention and control of infections,surface decontamination, improved access to antimicrobials and quality diagnostics,
development of newer vaccines, improved access to water, sanitation, and hygiene, antimicrobial
recycling, better agricultural practices, and strengthening health systems. It would also entail
identification of barriers during the uptake and scale up of the innovative approaches/tools
as well as evaluation of their cost effectiveness. R&I should establish a sound rationale todesign pilot interventions, as well as to prove their effectiveness through defining metrics andmeasures. The pilot interventions could be either technical or social. R&I is also needed to
identify the barriers preventing the uptake of a proven intervention and its implementationand to develop strategies to overcome these barriers. The cost-effectiveness of an intervention
as well as its acceptability and adaptability to different settings and countries/local contexts is
crucial and needs to be well investigated.

OHAMR Strategic Research and Innovation Agenda

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A European Partnership on One
Health AMR to support AMR
Research and Innovation
The European partnership on One Health AMR (OHAMR) is one of the key European partnershipsthat has been identified by the European Commission (EC) within the framework of the Horizon
Europe R&I programme39 to respond to the challenges of AMR described in the earlier section.
The OHAMR will enhance coordination and alignment of actions among EU countries and beyond,and boost investments to support cross-sectorial R&I in the fight against AMR. The efforts of
the OHAMR are in alignment with the “Council Recommendation on Stepping up EU actions tocombat antimicrobial resistance in a One Health approach”40 and with the European Parliament
recommendation on antimicrobial resistance41, two recommendations underlying that support
to research is crucial for the development, evaluation and implementation of measures against
AMR. The OHAMR will also contribute to achieve the objectives identified in the “EU One Health
Action Plan against AMR”42.
The specific objectives of the OHAMR will be to:•••Enhance European and global synergy, multi-sectoral and multidisciplinary collaboration, andalignment of strategic OH AMR R&I and policies to break silos;
Boost AMR research & innovation to generate knowledge and develop solutions to preventand tackle AMR;
Facilitate knowledge valorisation of research and innovation into products, policy and practice.

The OHAMR builds on the experiences and well-established networks and processes of the
Joint Programming Initiative on AMR (JPIAMR). However, the OHAMR extends to a broader
and more integrative programme to further strengthen synergy and enable cross-sectoral andinterdisciplinary research, including social sciences and economics, through a holistic One Healthapproach. In addition, the OHAMR has stronger elements of innovation and uptake of solutions
by industry, society and policy makers through reinforced engagement with stakeholders, aswell as capacity strengthening and data facilitation. Furthermore, the OHAMR aims to expand
international networks and attract new partners from the EU and beyond.
The OHAMR will reduce duplication of efforts by promoting coordination and alignment of
national, EU and international AMR R&I policies and actions, and by increasing collaboration

39

Horizon Europe Work Programme 2023-2024, Health40

Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach (13 June 2023)

41

EP resolution on Prudent use of antibiotics and more research needed to fight AMR (1 June 2023)

42

EU One Health Action Plan against AMR (2017).

OHAMR Strategic Research and Innovation Agenda

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between human health, animal health and environment actors, as well as between different
scientific disciplines. The OHAMR will thus result in increased knowledge, solutions and evidencebase to understand, prevent and tackle AMR, thereby strengthening the European Research andInnovation Area (ERA) ecosystem and contribute to making the EU a best-practice region on AMR.
AMR is a complex problem which will need cooperation of multiple related and relevant research
programmes. The OHAMR will work in close collaboration and seek synergy with other European
partnerships and international initiatives (see section 8 for more details). In particular, the OHAMR
will be in close contact with the European Partnership on Animal Health and Welfare (EUP AH&W)
to seek synergies, collaborate on joint activities engage and avoid overlaps in the areas of AMR
and animal health. Most R&I on AMR in non-zoonotic, veterinary pathogens for food-producing
animals will be covered by the EUP AH&W whereas, the OHAMR will address transmission of AMR
from animals to humans such as in the case of wild-life and companion animals. The OHMAR will
also seek synergy and collaboration with other EU partnerships, such as Global Health European& Developing Countries Clinical Trials Partnership Joint Undertaking (GH EDCTP3-JU), Fostering
European Research Area for Health Research (ERA4Health), and Pandemic Preparedness, thatwill cover clinical trials for infectious diseases. The OHAMR will also collaborate closely with thesecond Joint Action on Antimicrobial Resistance (JAMRAI-2) to provide a scientific base for the
implementation of guidelines and national action plans.
The present OHAMR Strategic Research and Innovation Agenda (SRIA) serves as the strategic
foundation of the partnership to guide its future actions and support the development of its
annual work plans. The SRIA has been developed based on a large number of consultations (please
consult Annex 1 for more details on the SRIA development process). This SRIA has been draftedin collaboration with the WHO and the quadripartite organisations43 to ensure an alignment with
their respective AMR agendas44,45.

The Quadripartite organisations: the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme(UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH)

43

44

WHO Global research agenda for antimicrobial resistance in human health (2023)

45

Quadripartite A one health priority research agenda for antimicrobial resistance (2023)

46 Hedman, H, et. al (2020), A Review of Antimicrobial Resistance in Poultry Farming within Low-Resource Settings, Animals

OHAMR Strategic Research and Innovation Agenda

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Food animal production is rapidly expanding as well as the use of antibiotics
to improve meat production through increased feed conversion, growthrate promotion and disease prevention. The promotion of intensive poultry
farming could address issues of food security, but it may also increase risksof AMR exposure to poultry, other domestic animals, wildlife, and humanpopulations through the residues of the antibiotic residues in the food and in
the environment. 46

OHAMR Strategic Research and Innovation Agenda

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The OHAMR: Vision, Mission,and Values
VisionReduce the burden of AMR
The common vision of the OHAMR is to improve our response to the threat of AMR by reducing
the spread of AMR in humans, animals and the environment through an integrated One Healthapproach, and by increasing the number of effective treatment options available in the different
One Health sectors.

MissionTo boost One Health research and innovation leading to improved surveillance of resistantpathogens, better diagnostics and effective treatment of infections and to prevention
measures reducing the use of aWWntimicrobials and spread of AMR
The OHAMR will strengthen synergy and improve links between One Health R&I by better
coordinating activities and investment and by developing common objectives for participating
countries. It will implement concrete actions for breaking silos, boosting R&I, and development ofsolutions based on a joint and agreed Strategic Research and Innovation Agenda to understand,prevent and tackle AMR.

ValuesOne Health
The “One Health approach” in the partnership will focus on better understanding how the use of
antimicrobials and the spread of resistant microorganisms and resistance determinants in and/or
between humans, animals and the environment contribute to the emergence and spread of AMR
in humans and to its health consequences, and which interventions are effective to control AMR(figure 2).

OHAMR Strategic Research and Innovation Agenda

24.

Figure 2. One Health focus of the OHAMR.
The OHAMR will do a continuous effort to break the silos between the different sectors,
by stimulating discussion and collaborations, agreeing on common objectives, and boost
investments for intersectoral research. The OHAMR aims to act as a platform to connect
the different sectors, at all decision levels (researchers, end-users, funders, ministries). The
OHAMR will engage actively with other European Partnerships having a focus on animal health,environment and agriculture to guarantee a synergy of actions and avoid overlaps between the
different programmes (see also the section on Synergy and Collaborations)47.
Equality, Diversity, and Inclusion
Pathogens circulate on Earth without geographical borders and impact individuals whatever theirgender, age or socio-economic settings, making AMR a global threat. However, infections and
AMR affect different human populations differently. Treatment regimens adapted for children
are lacking, reinforcing their risk to AMR. While, in Low- and middle-income countries (LMICs),
resistant infections are mainly driven by less access to second- or third-line antimicrobials anddiagnostics, limited surveillance, lack of antimicrobial stewardship, lack of hygiene and proper
sanitation, inadequate infection prevention measures, inadequate infrastructure for managing
human and animal waste streams. In High Income countries, AMR is largely driven by highconsumption of antimicrobials for medical use, and by an inequality of access to healthcare
system (low-resource populations). Additionally, men and women are not exposed to AMR ina similar way and their adherence to treatment protocols differ. The present SRIA intends to47
In particular, the OHAMR will be in close contact of the Partnership on Animal Health and Welfare (EUP AH&W). Resistance affecting non-zoonotic,
veterinary pathogens for food-producing animals is one of the focus this partnership and some of the animal

OHAMR Strategic Research and Innovation Agenda

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cover the R&I priorities relevant for populations living in different socio-economic, demographic
or geographical context. The SRIA preparation involved a wild range of stakeholders including
experts from different backgrounds and geographic origins, as well as different end-users’
networks such as EPHA48 and PENTA49 to reflect the challenges of AMR in the society, at large.
The drafting of this SRIA has also been subjected to different consultations involving global
representations to highlight the respective challenges (see the Annex 1 for more details).
R&I to be supported in the framework of the OHAMR will adhere to the principles of social andgender equity, cultural sensitivity and economic viability while addressing the challenges of
AMR as well at an organisational level including, the composition of the consortia, leadershipand management of R&I projects. The OHAMR will also promote the inclusion of social sciences
and implementation science in its R&I efforts to ensure that economic, geographical, social,
behavioural and environmental contexts will be considered at all stages of the R&I planning andimplementation. R&I projects to be supported by the OHAMR will undertake an intersectional andmulti-dimensional approach by integrating sex, gender and other individual and population-level
determinants of health (such as age, socio-economic status, ethnicity, religion, class, caste, andother factors) into the project’s design, implementation, monitoring, evaluation and knowledgetranslation activities and plan context-specific interventions that are accessible and affordable tothe community.
Strengthening of the European Research Area (ERA)The OHAMR aims to strengthen Europe resilience to the emerging threat of AMR through abetter coordination and alignment of actions and research funding investments among EU
countries and beyond. It will facilitate national coherence of research programmes, including
various aspects and sectors of AMR R&I (e.g. human health, agriculture, environment, industry).
The OHAMR will leverage investments, avoiding unnecessary duplication of efforts and willthus provide support for scaling up R&I efforts. By strengthening the capacity of the researchcommunity, the OHAMR will support the sharing of best practices within Europe and beyond,especially towards widening countries50 and countries that are highly affected by the burden of
AMR. Emphasis will be laid also to support the early career scientists across all sectors, disciplines
and boundaries to gain expertise and facilitate their integration to the research community. By
creating a platform for knowledge valorisation, the OHAMR also aims to identify and remove
the barriers for innovation and to support the transfer of knowledge to industry and small andmedium enterprise, reinforcing the long-term competitiveness of Europe.

48

European Public Health Alliance49

Paediatric European Network for Treatment of AIDS

50

European Commission: Horizon Europe Widening – Who should apply?

OHAMR Strategic Research and Innovation Agenda

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Knowledge Valorisation
Enhanced knowledge translation and uptake of research and innovations into solutions andevidence-based policy is one of the main objectives of the OHAMR. Through the various
programmes on transnational R&I calls, capacity strengthening, data exploitation and knowledge
mobilisation, OHAMR will ensure that the knowledge generated from funded R&I projects aretransformed into sustainable solutions available for uptake for broad societal use and maximal
impact (see the section related to the “Impact Programme for knowledge mobilization” further
details). This includes knowledge dissemination, which involves making R&I findings known,
accessible and available for uptake for the benefit of the society as well as providing a framework
for engagement of the knowledge generators with the knowledge-users. The OHAMR will also
facilitate skill development and cross-fertilisation of competences and strengthen capacity of
researchers. The measures for knowledge dissemination, uptake and translation will be integrated
throughout the overarching activities of the OHAMR. This will help support the researchers/
innovators to receive a clear understanding of the societal and public health impact as well as
market opportunity, and route to translation of innovation and evidence through collaboration
between academia and industry. The approaches will be solution-oriented and transdisciplinary
and involve implementation research, social and behavioural sciences covering the OH sectors.
The OHAMR will thus facilitate the dissemination, transfer, and uptake of the knowledge
generated through valorisation.

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Focus areas of the OHAMR
A prioritisation exercise organised during the preparation of the OHAMR resulted in theidentification of three challenge-driven focus areas that should be addressed by the OHAMR:•••

Prevent the emergence and spread of AMR
Strengthen appropriate use of antimicrobials and infection prevention and control
Provide innovative and cost-effective treatment options

These three focus areas will guide the development of the annual joint transnational calls andactivities. Each focus area includes topics and sub-topics from more than one thematic area
(Transmission and Evolution, Therapeutics, Diagnostics, Surveillance, Interventions for prevention
and mitigation, see figure 3). These topics and subtopics should be seen as examples and are notexhaustive. Each focus area covers different disciplines (i.e. biological sciences, chemistry, social
sciences, engineering) and includes fundamental, translational and implementation research aswell as innovation.
The section below presents the three focus areas briefly. More details on the research andinnovation sub-topics included under the focus areas could be found in Annex 2 and in the
Roadmap of actions51. An update of the OHAMR SRIA is foreseen after the three first years of thepartnership, leaving the possibility to add emerging focus area(s), if needed.

Figure 3. Relationships between the thematic areas and the Focus Areas.

51

Roadmap of action (2025-2032) of the OHAMROHAMR Strategic Research and Innovation Agenda

28.

Focus Area 1: Prevent emergence and spread of AMR
Challenge
Current measures to decrease and control the emergence and spread of AMR and recent
technical advances are still insufficient to reduce the burden of AMR. In addition, it is still unclear
how the recent measures taken in some sectors, such as the reduction of antimicrobial use inanimal husbandry or the restriction of some critical antimicrobials for human cure only, will
have an impact on human health. In the coming years, novel and/or improved measures need to
be developed to control AMR, based on a better understanding of the mechanisms driving the
emergence, evolution, selection, persistence, and transmission of AMR, in and between different
OH sectors.
Objectives• Identification and characterisation of the factors (molecular, behavioural, ecological, social,societal, economic and environmental52) and mechanisms driving the emergence, evolution,
selection and maintenance of the resistance genes and resistant microorganisms.
• Identification and characterisation of the risks, drivers, scale and direction of the AMR
transmission routes within and between the different OH sectors, utilising mathematicalmodelling and approaches based on Artificial Intelligence (AI).
• Development of innovative solutions to limit the discharge, persistence, accumulation of
antimicrobials and resistant genes/micro-organisms in the environment.53• Comparison of existing interventions aiming to limit AMR emergence and spread, andevaluation of their impact on AMR, as well as their social, societal and economic benefit.
• Development of solutions to improve the access to social and technological innovations andinterventions aiming to reduce AMR emergence and spread, and to facilitate their availability
and their uptake by end-users.
•

52
Factors responsible for an inappropriate Antimicrobial use (AMU) will be covered by the focus area 2: “Strengthen appropriate use of antimicrobials
and infection prevention and control”.
53
A broad definition of environment is used throughout the document, including social and physical environment, in vivo environment (e.g.
microbiota) and wildlife.

OHAMR Strategic Research and Innovation Agenda

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Inappropriate use and overuse of antibiotics are one of themain drivers of AMR and have a detrimental impact on theeffectiveness of these critical medicines. Curbing the overuse
and misuse of antimicrobials in humans, animals and plants isvital to reduce the number of drug-resistant infections. 54

OHAMR Strategic Research and Innovation Agenda

30.

Focus area 2: Strengthen appropriate use of antimicrobials and infection
prevention and control
Challenge
AMR is, to a large degree, driven by misuse and overuse of antimicrobials and poor infection
prevention and control practices, in multiple sectors including human health, animal health,aquaculture, agriculture and horticulture.
Objectives• Identification and characterisation of the behavioural and social/societal factors leading to an
appropriate or excessive use of antimicrobials.
• Design of social and technical innovations, including diagnostics and digital tools, aiming tofacilitate the appropriate use of antimicrobials.
• Design of social and technical innovations aiming to prevent or reduce the incidence of
infections.
• Comparison of existing interventions aiming to reduce antimicrobial use or prevent infectious
diseases and evaluation of their impact on human health, as well as their social, societal andeconomic benefit.
• Identification of barriers to uptake of and access to social, societal and technologicalinnovations aiming to improve antimicrobial use and prevention of infection, anddevelopment of solutions to overcome these barriers.

Focus area 3: Provide innovative and cost-effective treatment options
Challenge
Resistant drug infections are responsible for an increasing number of treatment failures, increased
mortality and decreased food productivity.
Objectives• To develop new antimicrobials, novel treatment protocols or alternative treatment therapies
against Human Infectious diseases along with their respective diagnostics.
• To improve, preserve and reinforce the clinical efficacy of the current treatment
antimicrobials.
• Identification of barriers to access, availability, quality and uptake of therapeutic solutions anddevelopment of solutions to overcome those barriers.
• Assessment and prediction of the impact of economic incentives and regulations on drug
development, drug production, drug supply and treatment availability.

54

Klein, E, et al. (2018) Global increase and geographic convergence in antibiotic consumption between 2000 and 2015, PNASOHAMR Strategic Research and Innovation Agenda

31.

Programmes and actionsof the OHAMRThe OHAMR will implement different actions to fulfil its mission. These actions will be structured
in four different programmes (figure 4):••••

R&I Funding programme: to provide financial support to AMR R&I
Capacity Strengthening Programme: to support training, networking and collaboration acrossdisciplines, sectors, countries and career stages.
Data Exploitation Programme: to facilitate and promote access, sharing and (re) use of data
and research infrastructures
Impact Programme for knowledge mobilisation: to facilitate uptake of research results into
products, practice and policy for maximum societal impact

Figure 4. The four programmes and the three focus areas will contribute to tackle the OHAMR
objectives.

OHAMR Strategic Research and Innovation Agenda

32.

The execution of the calls and all measures to be included in calls will be handled by the R&I
Funding programme, whereas the other programmes will be responsible to coordinate andorganise additional activities and events (figure 5). The other programmes may also contribute to
the drafting of the annual call based on the needs identified in the mapping exercises conductedby the respective programme. Training activities will be performed by the Capacity strengthening
programme in collaboration and cooperation with the Impact programme and the Data
exploitation programme.

Figure 5. The connections and cooperation areas of the four OHAMR programmes.
An annual work plan will be developed and detailed every year for the following year to describe
the activities that will be performed by each programme. This will include the identification of
topics and sub-topics for joint transnational R&I calls directed to one of the focus areas, as wellas additional activities to strengthen research capacity, facilitate data (re)use and maximise
impact. The prioritisation will rely on the needs expressed by the research community, by the
stakeholders and by the OHAMR partners, but also on the preliminary assessment of the activities
organised during the past years, and on the resources available. The process will be coordinatedto develop a coherent annual work-plan and to increase synergy between the different
programmes across the different years.
The sections below briefly present the four programmes. More details on the different
programmes can be found in the Roadmap of actions55.

55

Roadmap of action (2025-2032) of the OHAMROHAMR Strategic Research and Innovation Agenda

33.

R&I Funding Programme
The objective of the R&I funding programme is to provide financial support to OHAMR R&I
through the organisation of annual competitive joint transnational calls co-funded by OHAMR
national/regional funding partner organisations and the EC. The R&I funding programme will
cover the planning of the calls (selection of the scientific topics, funding instruments and measures
to be integrated in the calls), their implementation (proposal submission and the selection
process) and the monitoring of the funded projects. The launch of one joint transnational call is
expected each year (exceptions with more than one call a year may exist). The calls will be opened
to researchers and innovators at universities, hospitals, other research performing organisations,and private actors, covering a wide range of scientific disciplines. Inclusion of stakeholders (suchas local authorities or patient associations) in the research consortia will also be welcome. The
eligibility criteria will depend on the funding partner organisations engaged in the calls.
The calls will support different types of research and innovation activities (figure 6), including:••••

Basic research projects - addressing fundamental research questions;Innovation, translational research projects - for research translation to technologicaldevelopment, proof of concept studies and innovations;
Implementation research projects – testing evidence-based solutions and interventions
assessing effectiveness in real world contexts;
Networks to identify current knowledge gaps; identify new research questions and agree oncommon methods/ metrics/ guidelines. Networks could also support knowledge transfer,
uptake of research results, practices and innovations and provide platforms for cross-sectoraland cross-disciplinary collaboration.

Figure 6. Type of research and innovation activities covered by the call.

OHAMR Strategic Research and Innovation Agenda

34.

In addition to the R&I activities, the call will also support additional activities aiming to support
capacity strengthening, data/resources sharing, knowledge transfer and valorisation performedby the funded R&I consortia.
Separate peer review panels and multiple ranking lists will be used if needed to ensure a fair
distribution of grant funding between different call topics and funding instruments.

Capacity Strengthening Programme
The capacity strengthening programme aims to strengthen the ERA and leverage the capacity of
AMR researchers of different career stages and from diverse scientific backgrounds, OH sectors,
professional sectors, gender and geographic origins (including widening countries and LMICs).
The objectives of the programme are:•••

To leverage technical and non-technical skills needed to meet the AMR challenges
To strengthen the collaboration, knowledge exchange and mobility between researchersof different scientific disciplines, OH sectors, professional sectors and countries in EU andbeyondTo create a viable and sustainable AMR research community, including the support of Early
Career Researchers (ECRs) as an important segment of this community

To realise the goals of the programme the following activities will be organised:
•
•
•

•

•

Mapping of needs, barriers, actors and target groups for capacity strengthening
Training activities (e.g. in advanced technologies, in project management, in scientific writing,in communication, in entrepreneurship, on data management, on pathway to impact)
Activities to facilitate connections, collaborations, mobility and knowledge exchange
across sectors, disciplines and countries (e.g. mobility programme, match-making events,
conference, workshops to share good practice, directory of researchers)
Activities to facilitate career progression of the early career scientists (e.g. fellowship
programme tailored for ECRs, establishment of a network of ECRs, mentorship programme,
contests dedicated to ECRs)
Activities to promote an international engagement (e.g. sharing of best practices, mobility
programme, engagement with international funders and stakeholders)

OHAMR Strategic Research and Innovation Agenda

35.

The Capacity strengthening programme will work in close collaboration with the R&I funding
programme to ensure the integration of capacity strengthening measures within the joint
transnational calls (measures to promote ECR engagement, to promote the engagement ofresearchers working in widening countries and in low- and middle-income countries, to promote
public/private sector collaborations, to enhance the formation of interdisciplinary and crosssectorial consortia).
The programme is expected to result in the following outcomes:
•
•

•
•

AMR researchers equipped with a comprehensive set of technical and non-technicalproficiencies necessary to address the multifaceted challenge of AMR
Stronger collaboration among AMR researchers and stakeholders, spanning diverse researchdisciplines, One Health sectors, SMEs, and industries, fostering a deeper comprehension of
how each sector can contribute synergistically
Establishment of a robust network comprising the upcoming AMR researchers, ready toconfront the evolving AMR challenges
Improved AMR research capacity within the EU and beyond, encompassing widening
countries, and globally, extending support to Low- and Middle-Income Countries (LMICs),
fortifying the collective global capacity to combat antimicrobial resistance

Data Exploitation Programme
The data exploitation programme will support the AMR community to facilitate sharing and(re)using of data and research infrastructures to foster an effective and efficient control andprevention of AMR. The programme will therefore work towards implementing the FAIR
principles, as these guide the steps towards data to become findable, accessible, interoperable
and reusable for both people and machines (computers). It will be done through subsequentand feasible steps, considering the level of reusability of data resources in the funded projects aswell other resources. The ultimate goal would be that funded research and innovation projects
produce (or use) FAIR data that remain at their source, that can be visited by algorithms, and be
used by computer technology (data science, artificial intelligence). This would facilitate advanced
analyses on large amounts of data, from different domains, disciplines and geographical areas.
The programme will promote use and re-use of existing resources and research infrastructure
relevant in the field of AMR covering the OH sectors. The main objectives of the programme are:•To identify the stakeholders and users of AMR data and their needs to maximise the potentialof data (re)use from various sources within the OH AMR sectors to generate insights forresearch and policy;

OHAMR Strategic Research and Innovation Agenda

36.

•
•

•

To identify the needs, barriers and solutions for availability, interoperability and reusability of
AMR data resources and existing research infrastructure across OH sectors;
To develop an operational structure and framework to support researchers and data
stewards to produce FAIR data and facilitate different type of users’ access to AMR data andinformation;
To demonstrate how the produced (meta)data can be (re)used to tackle AMR research, policy
or public health issues with a One Health approach.

To realise the goals of the programme the following actions will be undertaken:
•
•

•
•
•

Engage the AMR community to identify the needs, resources and use of data in OH AMR
sectors to facilitate data harmonisation and interoperability.
Engage the AMR community to identify the needs of use of AI based approaches including
data mining and machine learning for advanced data analytics and insights on accelerating
drug discovery, improving infection diagnosis and antibiotic prescription, and AMR
surveillance for predicting disease outbreaks.
Contact, liaise and collaborate with relevant infrastructures active in the EU and beyond topromote use and re-use of existing resources in the field of AMR.
Develop data FAIRIfication framework so that data in the AMR research domain will be
optimally produced, and made available for (re-)use for human and machine.
Exploitation of the (meta)data to support AMR data use and reuse for policy and practice.

The programme is expected to result in the following outcomes:
•
•

•

•

Better findability and access for the research community to AMR data and information on
existing resources, and ability to use them in new and advanced research.
Improved awareness and facilitating the research community to use and produce reusable(and as much as possible FAIR) AMR data with the help of standardised and machineactionable descriptions of data and other resources.
Improved opportunities for data science and artificial intelligence with FAIRified (meta)data,
including advanced automated and integrated analyses on large AMR datasets from different
domains, regions and sectors.
Better interconnectivity of datasets from different OH-sectors to extract more value fromexisting data and to enable researchers, professionals, policy-makers and other stakeholders
for data-informed decision-making to prevent and control AMR.

OHAMR Strategic Research and Innovation Agenda

37.

Impact Programme for knowledge mobilization
The impact programme will facilitate the transfer, uptake and valorisation of the knowledge
generated from funded research and Innovation projects for maximum societal impact. It
aims to facilitate the translation of knowledge into solutions and sustainable uptake of AMR
interventions by providing a framework for collaboration between the knowledge generators(funded researchers and innovators as well as other AMR programmes and initiatives) and theknowledge-users, including policymakers, taking a One Health lens to mitigate AMR in diverse
socio-economic settings. The objectives of the programme are:•••To support the identification of unmet needs, ensuring calls for research and innovation
projects are informed by the relevant contexts, end-users and policymakers for generating
evidence to create maximum impact.
To facilitate the translation and uptake of innovation and the implementation of evidencebased AMR interventions for sustainable impact.
To provide a framework to support and engage with knowledge generators, knowledge users
and the relevant community for knowledge valorisation.

The programme is proposed to be executed by the “knowledge facilitators” who will act asintermediaries between the knowledge generators and relevant knowledge users and are
expected to:
•
•
•

•
•

Scope and identify unmet needs and gaps to inform and shape research and innovationquestions for generating evidence in the transnational calls;
Identify & map the added value and impact of R&I project findings for knowledge
mobilisation;
Facilitate the development of guidelines, recommendations and policy briefs where
researchers and policymakers jointly contribute to use evidence to inform policy, programmes
and practice;
Facilitate testing and implementing AMR-sensitive and -specific interventions supported
through the R&I funding programmes;
Provide support to R&I products (new leads, candidates, diagnostics, tools, technologies) toprogress for further development.

OHAMR Strategic Research and Innovation Agenda

38.

The knowledge facilitators will deliver on actions and activities directed to three strategic
tracks for innovation translation, implementation of evidence for practice and policy-making
under the programme engaging the knowledge generators and the users. The programme willconnect and engage with the existing actors and networks in the AMR field, globally, partner withdiverse stakeholders tapping their experience and expertise and avoid duplication of efforts toaccomplish the set objectives. The expected outcomes of the programme are:
•
•
•

•

Better informed R&I calls delivering on research for unmet needs to generate evidence forsocietal impact.
Equip researchers with translational knowledge to learn about the entire R&I ecosystem,
value proposition, end-users need and route to translation.
Enhanced research impact through translation of research findings into sustainable solutions,products, services and knowledge-based policies made available for uptake and broadsocietal use.
Deeper global cooperation and collaboration to maximise knowledge dissemination andtranslation.

•

OHAMR Strategic Research and Innovation Agenda

39.

Water bodies plays a critical role in the fight against AMR.
Antimicrobial residues and antimicrobial resistance genes
from different sources enter aquatic systems via wastewateror through run-off to surface water and leaching togroundwater that can drive the development and spread of
AMR from the environment to animals and humans.56

OHAMR Strategic Research and Innovation Agenda

40.

Monitoring of the progress of the
OHAMR towards its objectives
Monitoring the progress of the OHAMR is vital to assess the progress of the partnership towards
its goals, objectives and expected impact as well as for informing future actions. The goalsof the OHAMR are reflected in the various general, specific and operational objectives in thefollowing section. The outputs from the actions under each operational objective are expected tocontribute to the outcomes of one or more specific objectives, which combined, will contribute to
the expected impact generated from the general objectives as schematically represented in figure
7 and figure 8. Key performance indicators (KPIs) as proxies for measurement of progress towards
the various objectives and defining the underlying impact pathways is necessary to assess theshort and mid-term outputs and outcomes as well as longer-term socio-economic impact of the
OHAMR. The proposed KPIs, mentioned under each objective, include output indicators at theoperational level that can be interpreted after a short term, as well as mid-term and long-term
indicators for assessing outcomes and to demonstrate added-value, benefits and impacts forscience and society. The proposed KPIs are complementary to the common indicators on thefunctioning of European Partnerships and Key Impact Pathways (KIPs) of the Horizon Europe (asreferred to in Article III57).

56
57

World Economic Forum: The costs and risks of AMR water pollution
EU regulation establishing Horizon Europe – the Framework Programme for Research and Innovation

OHAMR Strategic Research and Innovation Agenda

41.

Figure 7. General, Specific and Operational objectives of the EUP OH AMR. All objectives areinterconnected and thus, each OO contributes to several SOs and each SO contributes to both GOs.

OHAMR Strategic Research and Innovation Agenda

42.

OHAMR Strategic Research and Innovation Agenda

43.

OHAMR General objectives and their key performance indicators
The general objectives will provide a basis for assessing the partnership in relation to longer term
and more diffuse effects (or global impacts). Indicators at this level are called impact indicators58.
GO1. Strengthen resilience to the AMR threat in Europe and beyond
The OHAMR will strengthen the resilience to the AMR challenge in the ERA by creating a
structured AMR R&I ecosystem with stronger inclusion of the widening countries. This system will
provide synergy and coordination of excellent basic research and innovation, increased capacity
strengthening, programmes for the development of talent, and widening measures to increase
the engagement of countries and stakeholders, as well as enhanced international collaboration to
mitigate the threat from global hotspots of AMR.

Potential impact indicators for GO1:•

Strengthened global cross-sectoral and cross-border One Health AMR R&I ecosystem◦ Strengthened cooperation of the ERA to support R&I to combat AMR◦ Strengthened capacity (talent, knowledge, data, tools, resources) and integration of a One
Health cross-sectoral and transdisciplinary AMR R&I ecosystem◦ Enhanced global collaboration for a strengthened OH approach to fight AMR expanded
beyond Europe

GO2. Enhance evidence-based policy measures and innovative solutions to prevent, detect,control, and treat drug-resistant infections in humans
The OHAMR will enhance research and innovation impact through translation of research findings,
including data, and know-how into sustainable products, services, solutions and evidence-based
policies made available for uptake and broad societal use to reduce the burden of AMR.

58

ERA Learn: Glossary of the most important terms for monitoring and evaluation.

OHAMR Strategic Research and Innovation Agenda

44.

Potential impact indicators for GO2:•

Knowledge, evidence-based measures and innovative solutions put into action◦ Application of knowledge generated through cross-border, inter-sectoral andinterdisciplinary R&I resulting in improved policies and understanding of AMR◦ Policy documents, guidelines, recommendations, strategic roadmaps generated utilisingresearch evidence from funded R&I project results◦ Innovative solutions fulfilling unmet medical needs of human patients and animals,
reducing the impact of AMR on food security and environment and contributing to thewellbeing of the society and delivering on EU meeting policy priorities and SDG objectives

OHAMR Specific objectives and their key performance indicators
The specific objectives will provide a basis for assessing the partnership in relation to the shortterm effects that occur. Indicators at this level are called outcome indicators.52
SO1. Enhance global and European synergy, multi-sectoral collaboration, and alignment of joint
strategic OH AMR R&I policies to break silos
The OHAMR will mobilise and link key AMR stakeholders and provide a framework to breakexisting silos across One Health sectors and scientific disciplines in the AMR R&I landscape in
the ERA, as well as globally. It will structure efforts to curb AMR and facilitate multi sectoralcollaboration and joint programming of actions between national and international, scientificand policy communities in coordination with industry, practitioners and end-users, with specificattention to widening and Low- and Middle-Income countries (LMICs).

Potential outcome indicators for SO2:•

R&I based knowledge generation and development of systems-wide solutions◦ Number of prediction models on risk assessment on AMR emergence and spread◦ Number of antimicrobial targets and candidates, therapeutic alternatives, new andimproved diagnostics developed◦ Number of innovative products, processes or methods resulted (including IPRapplications); creation of start-ups/companies as drivers of innovation◦ Number of evidence-based treatment regimens, stewardship measures and preventive
solutions and mitigation measures developed

OHAMR Strategic Research and Innovation Agenda

45.

SO3. Facilitate knowledge valorisation of research and innovation into products, policy andpractice
The OHAMR will facilitate innovation translation and implementation of AMR-sensitive and-specific interventions supported through the R&I funding programmes into products, measures,
solutions and development of evidence-based policy in the OH AMR domains.

Potential outcome indicators for SO3:•

Knowledge mobilisation for innovations and implementation◦ Improved dialogue and knowledge exchange between researchers, industry, data
stewards, policymakers and other end-users◦ Number of original research articles, guidelines, recommendations, strategy roadmaps
published (with open access status)◦ Number and type of R&I project outcomes (data, technical tools, protocols and guidelines)
and resources generated and made available as FAIR in open platforms◦ Number of projects funded developing links between data/research resources orplatforms/infrastructures across sectors and disciplines◦ Share of projects with R&I outcomes adopted for implementation of solutions/products
and/or as base for creation of (start-up) companies◦ Scientific basis generated by the research projects for the development of potential
regulatory framework/legislation proposals/policy◦ Number of products/innovations transitioning to an advanced TRL maturity in pipeline
development◦ Number and types of R&I outputs that are disseminated in a format accessible for end
users and citizens at large (e.g. videos, infographics, summaries, social media campaigns)

Operational objectives and their key performance indicators
The Operational objectives will provide a basis for assessing the partnership in relation to its
outputs that is directly produced/supplied through the activities and actions carried out during
the implementation process. Indicators at this level are called output indicators.52

OHAMR Strategic Research and Innovation Agenda46.

OO1. Coordination and prioritisation of R&I activities to avoid fragmentation and duplication ofefforts across countries and sectors
The OHAMR will stimulate collaborative activities between EU and Member States, associatedcountries, LMICs and other international initiatives to increase commitment and investment for
R&I actions. Provide regular/periodic platforms for information exchange with other partnerships/
initiatives and multiple groups of sectoral and disciplinary stakeholders within and outside Europe
will be established to identify prioritised research and innovation objectives targeted to the actual
needs (challenge-driven) of societies for stronger OH AMR global cooperation. The OHAMR will
also establish governance mechanisms and platforms for regular, periodic cross sectoral and crossdisciplinary collaborations between funders and a broad range of stakeholders to capitalise on
synergies and continue development of the joint SRIA/Roadmap of Actions.

Potential output indicators for OO1:•

Global stakeholder engagement◦ Establishment of platform among countries (policymaker, regulator), funders/donors,
sectoral researchers and industry stakeholders within and outside Europe◦ Membership growth (number and diversity of funding organisations)◦ Joint investment committed for OHAMR R&I actions◦ Diversity of engaged stakeholders (e.g. public, private, geographical and sectoral diversity)◦ Participation of Widening countries and LMICs•

Joint synergistic activities◦ Number and type of activities with other HE partnerships◦ Number and type of activities to facilitate synergies beyond Europe◦ Number of partnerships established between Europe, LMIC and widening countries
research management bodies/ AMR programs◦ Continued development of the joint SRIA and roadmap of actions

OO2. Increase joint support of One Health R&I actions mitigating the threat of AMR
strengthened through co-creation by end-users
This objective will reflect and encompass the One Health R&I actions through annual joint
transnational calls to support cutting edge research with increased funding, new modalities andapproaches and strengthen trans- and interdisciplinary and inter-sectoral research. Support fortranslational research for the development of (challenge-driven) innovative solutions as well

OHAMR Strategic Research and Innovation Agenda47.

as basic, and implementation research and innovation projects, research networks and othermeasures will be provided. This objective will be further refined with detailed descriptions of
R&I actions corresponding to the prioritised topics identified under the focus areas selected
for calls and other activities integrating cross-cutting issues including socio-economic andglobal aspects, implementation science and innovation in R&I actions. Funded activities will bemonitored by a structured framework for collection of research and innovations outputs andother relevant indicators.

Potential output indicators for OO2:•

Upskilled researchers and increased research capacity◦ Share of research and innovation partners in funded projects representing different typesof organisations (academic, industry, public health, civil society etc.)◦ Number of Early Career Researchers funded in research projects as well as undertaking
mobility programmes, mentoring, training, and benefitting from capacity and careerbuilding programmes◦ Number of researchers funded from Widening countries◦ Number of researchers funded from LMICs◦ Knowledge transfer activities targeted to LMICs and widening countries◦ Number and type of activities facilitating and/or supporting sharing and (re)use of AMR
data/research resources

OO3. Support career and capacity strengthening programmes to create a sustainable AMR
research community
The OHAMR will utilise various funding instruments to support mobility, promote networking,collaboration, and knowledge exchange between researchers of different scientific disciplines,
OH sectors, professional sectors and countries in EU and beyond. Support for AMR researchersof different career stages and from diverse scientific backgrounds, OH sectors, and geographic
origins is anticipated. Activities to strengthen research capacity in under-represented countries(including widening countries) and in LMICs is also anticipated to promote international
engagement.

OHAMR Strategic Research and Innovation Agenda

48.

Potential output indicators for OO3:•

Upskilled researchers and strengthened research community◦ Share of research and innovation partners in funded projects representing different typesof organisations (academic, industry, public health, civil society etc.)◦ Number of Early Career Researchers funded in research projects as well as undertaking
mobility programmes, mentoring, training, and benefitting from capacity and careerstrengthening programme◦ Number of researchers funded from LMIC and widening countries◦ Knowledge transfer activities targeted to LMICs and widening countries◦ Number of transversal activities to promote collective mutual learning and exchange ofknowledge and solutions between sectors and countries

OO4. Facilitate access to AMR research resource platforms and enable sharing and (re)use of
FAIR data
The OHAMR will support the research community to use and produce reusable FAIR AMR datawith the help of standardised and machine-actionable descriptions of data and other resources.
Opportunities will be also explored to utilise data science and machine learning with FAIRified(meta)data for advanced automated and integrated analyses on large AMR datasets fromdifferent domains, regions and sectors. It will facilitate better findability and access for the
research community to existing research infrastructure on AMR data and information.

Potential output indicators for OO4:•

Data sharing and (re)utilisation of resources◦ Number and type of activities to inform and engage researchers on available data
platforms, research infrastructure, resources and tools for reuse and data sharing.
◦ Number and type of activities to support researchers gain FAIR data-expertise throughdata stewardship training with data experts to generate FAIR research outputs.
◦ Number and type of activities with the AMR community (domain and data experts) to
identify modern tools/methods for data sharing and advanced data analytics.

OHAMR Strategic Research and Innovation Agenda49.

OO5. Support dissemination of research results for knowledge exchange, transfer and uptake
by end-users
Activities and events will be conducted to connect knowledge generators (the scientificcommunity) with knowledge users (national, EU and international AMR policymakers, investors,
industries, civil society organisations) to support knowledge exchange with end-users for further
uptake into strategies, policies and practice. Furthermore, brokerage events to promote matchmaking between researchers, industry, incubators, accelerators and business angels to educate
and inform researchers about innovation, policy and implementation needs as well as explore
support mechanism for R&I products (new leads, molecules, diagnostics, tools, technologies)
to progress for further development. The OHAMR will also organise activities and events to
support societal engagement and disseminate research findings to a wider community, beyond
the academic audience, including civil society organisations to create better awareness of AMR
threats and solutions.

Potential output indicators for OO5:•

Community engagement and knowledge dissemination to end-users◦ Number and type of activities for engagement of projects with industry, regulators,
policymakers, and other end-users for dissemination of research findings for innovationand translation◦ Number of activities on science - policy interface, science communication, citizen science
etc involving researchers and end-users.
◦ Number and type of stakeholders engaged in early engagement and dissemination
activities (industry, regulators, policymakers, civil society) and other end-users

OHAMR Strategic Research and Innovation Agenda

50.

The OHAMR pathway to impact
This section highlights the OHAMR strategy map (figure 8) that will capture the relationships
between the various activities, their implementation and the expected outcomes and pathway toimpact including longer-term socio-economic impact through support of R&I actions. Many of theoutcomes and the impact are expected to materialise even after the partnership has completed
its activities. The indicators (as listed in the previous sections) forms the basis for measurement ofprogress and assessing the underlying impact pathway of the OHAMR.
The OHAMR will contribute to building a coherent European Research Area, reinforcing Member
States, countries associated to Horizon Europe and the European Commission as internationallyrecognised driver to jointly support R&I on AMR. The OHAMR will break the silos to form a strong
cross-sectoral ecosystem linking the diverse stakeholders encompassing the human, veterinary,
agricultural and environmental sectors. Through a joint strategic programming and global
coordination of R&I, the OHAMR will thus address various objectives of the EU One Health Action
plan against AMR59. It will address the priority “making Europe more resilient” of the Horizon
Europe Strategic Plan60 by responding to the emerging threat of AMR.
The OHAMR will contribute to a sustainable transformation of health care, food production, theenvironment and society at large. The OHAMR will contribute to the objectives of the Farm2Fork
strategy61, by promoting sustainable food production and enhance food safety and security, as
well as the Zero Pollution Action Plan62, by addressing the spread of AMR in the environment andthus address the objectives of the European Green Deal initiatives63. The OHAMR will also address
the objectives of the Pharmaceutical Strategy for Europe64, in terms of fulfilling unmet medical
needs on AMR and ensuring that the benefits of innovation reach patients in the EU and beyond.
The OHAMR will help unlock the potential of new tools, digital technologies and solutions andbuild towards a more harmonised data-enabled digital R&I environment for diagnosis, therapy,
surveillance and prevention of AMR. Utilising data science and AI, OHAMR will support use ofmodern tools and technologies for advanced automated and integrated analyses on large AMR
datasets from different disciplines and sectors and will contribute to Europe’s strategy for digitaltransition65. By delivering increased knowledge, and evidence-based solutions to prevent andtackle AMR, the OHAMR will thus contribute to making the EU a best-practice region on AMR.
By coordinating national research efforts on AMR, in EU, but also beyond EU, the OHAMR will
also have an important role to shape the global Agenda, thus reinforcing Europe’s leading rolein the fight against AMR. The OHAMR contribute to the UN SGD good health and wellbeing
by decreasing the burden of infectious diseases due to antimicrobial resistant pathogens andpreparing for emerging threats as depicted in the impact pathway map represented schematicallyin figure 8.

59

A European One Health Action Plan against AMR (2017)60

The Horizon Europe Strategic Plan 2021-2024

61

The Farm2Fork Strategy (2020)

62

EU Action Plan: “Towards a Zero Pollution for Air, Water and Soil” (2021)

63

The European Green Deal

64

A Pharmaceutical Strategy for Europe (2020)

65

Shaping Europe’s digital future

OHAMR Strategic Research and Innovation Agenda

51.

Figure 8. The OHAMR pathway to impact. The pathway links the resources of the OHAMR and theactions to be undertaken towards specific outcomes to achieve multiple general objectives whichthen result in domain specific impact. All outputs are interconnected and thus, each contributes toseveral outcomes and each outcome contributes to different impact.

OHAMR Strategic Research and Innovation Agenda

52.

OHAMR Strategic Research and Innovation Agenda

53.

Synergies and Collaborations withother Partnerships, initiatives andStakeholders
The AMR challenge cannot be solved by a single partnership. Synergies, complementarities
and collaboration among the existing and planned partnerships and initiatives are of utmost
importance. The OHAMR will therefore engage with these initiatives on a regular basis to identify
synergies, plan potential joint activities and avoid duplication of efforts. Synergies and potential
collaboration opportunities have been identified and listed in the table 1–3 below.
Table 1. Relevant European Partnerships within Horizon Europe Cluster 1 (Health).
Partnership

Objectives

Global Health European& Developing Countries
Clinical Trials Joint
Undertaking, (GH EDCTP
3-JU)

The Global Health EDCTP3
Joint Undertaking will support
international research
partnerships accelerating theclinical evaluation of drugs,
vaccines and diagnostics for key
infectious diseases affecting subSaharan Africa, as well as novel
approaches for surveillanceand control of emerging/re-emerging infections in theregion and globally. It will also
strengthen clinical research
capacity in sub-Saharan Africa.

Pandemic Preparedness• Potential collaboration on antiviral andThis partnership aims to
antiparasitic resistance, as well as on clinicalimprove the EU’s preparedness
trials.
to emerging infectious healththreats by better coordinating
R&I at EU, national (andregional) level, to develop
solutions and tools to prepare,predict, prevent and respondto emerging infectious diseases
and pandemic outbreaks,
and to assure that research
infrastructures (including Clinical
trial platforms) could be ready tooperate in case of pandemic.

OHAMR Strategic Research and Innovation Agenda

Potential synergies and collaboration• Potential synergies on capacity strengthening.
• Exchange of information and peer-learning.
• Alignment of calls.
• Potential joint workshops for dissemination anduptake of research results.

54.

Partnership

Objectives

Potential synergies and collaboration

Personalised Medicine,

The vision of the European
Partnership for Personalised
Medicine (EP PerMed) is toimprove health outcomes withinsustainable healthcare systems
through research, development,
innovation and implementationof personalised medicine
approaches for the benefit ofpatients, citizens, and society.

• Potential synergies and collaboration
opportunities on information exchange,
dissemination, awareness-raising and otheractivities.

(EP PerMed)

ERA for Health Research,(ERA4Health)

ERA4Health focuses on tacklingdiseases and reducing disease
burden by addressing thefollowing challenges:• The increasing demand fora better quality of life and abetter patient care.
• The need to transform publichealth care systems into
more effective, efficient,equitable, accessible, andresilient ones.

• Personalised antimicrobial therapies.

• Exchange of information and peer-learning.
• Potential synergies and collaboration
opportunities on stakeholder engagement,
dissemination to policy and communication
towards the public.
• Collaboration on European clinical trials
networks mapping and on nanotechnologies
for improved antimicrobial delivery.

• The need to strengthen
disease prevention andhealth promotion.
Transforming Health andCare systems (THCS)

THCS aims to bring together
stakeholders, create synergies,
coordinate Research andInnovation actions, facilitate
the digitization of health andcare services and support thetransformation of health andcare systems with innovative
solutions driven by knowledge
and evidence.

Innovative Health
Initiative Joint
Undertaking (IHI JU)This public private partnershipaims to translate health researchand innovation into benefits
for patients and society. It
covers prevention, diagnostics,
treatment and disease
management.

OHAMR Strategic Research and Innovation Agenda• Exchange of information and peer-learning.
• Collaboration on antimicrobial stewardshipmeasures in Healthcare system• Exchange of information and peer-learning.

55.

Table 2. Relevant European Partnerships within Horizon Europe Cluster 6 (Food, Bioeconomy,Natural Resources, Agriculture and Environment).
Partenership

Objectives

Potential synergies and collaboration

EUP on Animal Health andWelfare (EUP-AH&W)

The EUP-AH&W’s general goals
are to progress Europe towards
healthy and sustainable livestock
production systems (for bothterrestrial and aquatic animals),
including the reduction ofanti-microbial usage, and to
greatly improve production
animal welfare, in line with theEuropean Green Deal and farmto-fork strategy.

• Alignment of joint translational calls andinternal calls.

Water4All – Water
security for the planet

Safe and Sustainable Food
Systems for People (PSFS)

Accelerating farming
systems transition:
agroecology livinglabs and research
infrastructures

Water4All’s Vision is to boost
the systemic transformations
and changes across the entire
water research –innovation- implementation pipeline,
fostering the matchmaking
between problem owners andsolution providers for ensuring
water security for all in the longterm.
The overarching vision of the
SFS Partnership is that its
actors collectively will achieveenvironmentally-friendly,socially secure and fair,economically viable, healthyand safe food systems in Europe
in order to help realise its goalsof the Farm to Fork strategy, inline with the global ambitions ofUnited Nations (UN) Sustainable
Food Summit 2021.
The partnership aims toaccelerate the transition
towards sustainable, climateand ecosystem-friendly farming
practices. To do so, it will 1)
enable a better comprehensionof agroecological processes
from farm to landscape levels, 2)boost place-based innovation inco-creative environments and 3)
improve the flow and uptake ofknowledge and innovations on
agroecology.

OHAMR Strategic Research and Innovation Agenda• Potential joint training and data sharing
activities.
• Regular contact will be held to align the
programmes.
• Sharing of results (notably on antimicrobial
use and antimicrobial surveillance in Animal
Health).
• Potential synergies on transmission routes inthe environment.
• Exchange of information and peer-learning.
• Collaboration on water pollutants.

• Potential Synergies on AMR in the food supply
chain.
• Exchange of information and peer-learning.
• Collaboration on AMR transmission (livestock/crop to human).

• Exchange of information and peer-learning.

56.

Table 3. Relevant European Initiatives within other EU funding programmes/clusters.
Partnership

Objectives

Potential synergies and collaboration• Synergies and potential collaboration on
EU-JAMRAI 2 will support MS/
Joint Action on
engagement with stakeholders and policyAntimicrobial Resistance 2 AC (Member States/Associatedmakers, dissemination/uptake and training
Countries) in their efforts(EU-JAMRAI 2)
activities.
to develop and update their
National Action Plans on AMR,
contributes to several EU4Healthpolicy priorities by strengthening
MS/AC coordination andresponsiveness against AMR,
ensuring the access to important
medicinal products and medical
devices and, protecting people
from AMR.
EIT HealthEuropean Open Science
Cloud (EOSC)

The ambition of EIT Health isto enable people in Europe
to live longer, healthierlives. The work goes beyond
conventional approaches todisease management anddisease prevention. We arebuilding and growing businesses
to create products and services
that progress healthcare inEurope, while strengthening our
economy.
The ambition of the European
Open Science Cloud (EOSC) is toprovide European researchers,
innovators, companies andcitizens with a federated
and open multi-disciplinary
environment where they canpublish, find and re-use data,
tools and services for research,innovation and educational
purposes.

• Exchange of information and peer-learning.
• Collaboration on R&I uptake by SMEs andIndustry and training activities.

• Potential Synergies on access and sharing ofdata.

The OHAMR will also interact with other initiatives and stakeholders to ensure maximum
synergies, share information and promote uptake of research results, as well as to avoid
duplication of efforts. These stakeholders will serve an important role to advice on strategicplanning and annual work programme development and to contribute with their expertise to
the activities planned by the different programmes. Some examples of such stakeholders are

OHAMR Strategic Research and Innovation Agenda

57.

mentioned below, but they should be seen as a preliminary and non-exclusive list. Continuous
information exchange, consultations and joint activities are foreseen throughout the duration of
the OHAMR.
International organisations and funders will be of importance to align and seek synergies on
research funding, capacity strengthening and implementation in countries outside the EU,in particular in LMICs. Such organisations include Action on Antibiotic Resistance (ReAct),
International Centre for Antimicrobial Resistance Solutions (ICARS), the Fleming fund, Wellcome,Bill & Melinda Gates Foundation, Team Europe Initiative Africa, Global AMR Innovation Fund(GAMRIF) as well as national initiatives, including those in LMICs and Widening countries.
Furthermore, the EUP OH AMR will also be in close contact with WHO, the UN Quadripartite andother international initiatives, such as the Global Leaders Group on Antimicrobial Resistance (AMR
Leaders) and the Global AMR R&D Hub, to align and seek synergy of agendas and R&I actions. In
addition, the OHAMR will utilise and build on the outcomes of ongoing EU-projects and initiatives,
such as One Health EJP and JAMRAI-2, as well as the national R&I projects in the AMR R&I
landscape for uptake and translation of R&I findings.
In order to facilitate translation and uptake of innovative solutions, the OHAMR will also
cooperate with international funding initiatives, such as the Combating Antibiotic ResistantBacteria Biopharmaceutical Accelerator (CARB-X), the Global Antibiotic Research & Development
Partnership (GARDP), FIND and the AMR Action fund. Engagement with industrial associations
like the Biotech companies from Europe innovating in Anti-Microbial resistance research (BEAM)
Alliance or the European Federation of Pharmaceutical Industries and Associations (EPFIA) will
also be sought.
To further ensure that solutions are readily disseminated to the society and that the supported
R&I respond to actual needs of the society, the OHAMR will utilise the AMR Stakeholder
Network, established at the European Public Health Alliance (EPHA), which brings together morethan 60 leading organisations and individuals, including patient groups, health professionalorganisations, NGOs for public health, veterinarians etc. at national, regional and European
level and thus is an excellent platform for stakeholder engagement, to advice on societal needs
and facilitation of uptake of research results and solutions. Social science networks like theInternational Network for AMR Social Science (INAMRSS) will also be important to engage with.
The OHAMR will also collaborate with training providers, such as the European Society of ClinicalMicrobiology and Infectious Diseases (ESCMID) and EIT Health, as well as with existing research
infrastructures and data sharing initiatives, such as the European life-sciences infrastructure
for biological information (ELIXIR), The Microbial Resource Research Infrastructure (MIRRI),
Biobanking and Biomolecular Resources Research Infrastructure (BBMRI), GO FAIR and the

OHAMR Strategic Research and Innovation Agenda

58.

European Health Data Space (EHDS).
The OHAMR will also interact with other relevant stakeholders and policy makers, such as EC
directorates (DGs) and EU agencies to align needs and provide scientific evidence-base forpolicy-making. These include DG for Research and Innovation (DG RTD), DG for Health and Food
Safety (DG SANTE, including the EU AMR One Health Network), DG for Agriculture and Rural
Development (DG AGRI), the Health Emergency Preparedness and Response department (HERA)
the European Centre for Disease Prevention and Control (ECDC), the European Food Safety
Authority (EFSA), the European Medicines Agency (EMA) and the European Environment Agency(EEA) (including the One Health cross agency task force66). In addition, the OHAMR will be in close
contact and align programmes of the WHO, the UN Quadripartite (including participation in the
AMR Multi-Stakeholder Partnership Platform) and other international initiatives, such as the
Global Leaders Group on Antimicrobial Resistance (AMR Leaders) and the Global AMR R&D Hub,the STAR-IDAZ International Research Consortium and the MedVetNet Association.

66

The EU agencies One Health cross-agency task force

OHAMR Strategic Research and Innovation Agenda

59.

Annex 1. SRIA development process
and plans for update
Development Process
The current SRIA has been developed by the Coordination and Support Action (CSA) DESIGN OH
AMR funded by the European Union (Grant Agreement N°101057036), in close collaboration with
the JPIAMR Scientific Advisory Board and other experts (see the list below), the JPIAMR member
states and the countries who expressed their interest to join the OHAMR.
Each section of the SRIA has been developed separately. The different sections were then
combined into a single document by the drafting team. A first version of the SRIA was subjected toa consultation (survey) directed to partners that had expressed interest to join OHAMR and someof the key stakeholders (eg EU agencies and other partnerships) in April 2023. A second version of
the document will be subjected to a second open consultation (survey) in May 2024. This second
consultation will be publicly opened and advertised through JPIAMR communication channels(newsletter, social media and website), through national communication channels, and through
EPHA (The AMR Stakeholder Network) communication channels. The participation of academic
researchers, end-users, SMEs, industry and stakeholders (including other partnerships, EU
initiatives and agencies, and EC directorates) will be encouraged. Efforts were made throughout
the process to consider the needs expressed by the different sectors (Human Health/Agriculture/
Environment, Academic/SME/Industry) and by different disciplines. The SRIA has been draftedin collaboration with the WHO and the quadripartite organisations67 to ensure an alignment with
their respective AMR agenda68,69. The OHAMR partners endorse the content of the SRIA. OHAMRSRIA will guide the actions of the OHAMR.
The document contains links to external third-party websites. The links to third-party sites do not
imply approval of their content. The CSA DESIGN OH AMR accept no liability for the accessibility orcontents of such websites and no liability for damages that may arise as a result of the use of suchcontent.

The Quadripartite organisations: the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme(UNEP), the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH)

67

68

WHO Global research agenda for antimicrobial resistance in human health (2023)

69

Quadripartite A one health priority research agenda for antimicrobial resistance (2023)

OHAMR Strategic Research and Innovation Agenda

60.

Experts directly consulted during the development process (by alphabetic order):• Ana Alastruey-Izquierdo, Instituto de Salud Carlos III, Spain*• Dan Andersson, University of Uppsala, Sweden• Till Bachmann, University of Edinburgh, United Kingdom*• Rafael Cantón, University Hospital Ramón y Cajal and Complutense University, Spain*• Teresa Coque, Ramón y Cajal Institute for BioHealth Research (IRYCIS), Spain• Tania Dottorini, University of Nottingham, United Kingdom*• Uga Dumpis, Pauls Stradiņš University Hospital, Latvia*• Sabiha Essack, University of KwaZulu Natal, South Africa*• Christian Giske, Karolinska Institute, Sweden*• Bruno Gonzalez Zorn, Complutense University, Spain• Luca Guardabassi, University of Copenhagen, Denmark*• Claire Harpet, Lyon 3 University, France*• Tom Harrison, St George’s University of London, United Kingdom*• Elena Ivanova Reipold, Foundation for Innovative New Diagnostics, Switzerland• Geetanjali Kapoor, Center for Disease Dynamics, Economics & Policy, India*• Joakim Larsson, University of Gothenburg, Sweden*• Marc Lemonnier, Antabio, France*• Nilton Lincopan, Universidade de São Paulo, Brazil*• Jean-Yves Madec, ANSES, France• Christian Menge, Friedrich Loeffler Institute, Germany• Chantal Morel, University of Bern, Switzerland*• Katherine Payne, University of Manchester, United Kingdom*• Luísa Vieira Peixe, University of Porto, Portugal*• Priscilla Rupali, Christian Medical College (CMC), Vellore, India• Etienne Ruppé, University Hospital Bichat and University of Paris, France• Jonathan Rushton, University of Liverpool, United Kingdom• Constance Schultsz, University of Amsterdam, The Netherlands*• Kornelia Smalla, Julius Kühn Institute, Germany*• Jordi Vila, Hospital Clinic in Barcelona, University of Barcelona and Institute for Global Health, Spain** Member of the JPIAMR Scientific Advisory Board during the period 2022–2024

Additional experts have been consulted, such as the Social Sciences working group:• Mónica Berger González, Universidad del Valle de Guatemala• Davide Bilardi, The Penta foundation, Italy• Alexander Broom, University of Sydney, Australia• Clare Chandler, London School of Hygiene & Tropical Medicine• Ian Donald, University of Liverpool, United Kingdom• Jon Pierre, University of Gothenburg, Sweden• Anja Schreijer, GCD Amsterdam, the Netherlands• Richard Smith, University of Exeter, United Kingdom

OHAMR Strategic Research and Innovation Agenda

61.

SRIA Update
An update of the OHAMR SRIA is planned three years after the launch of the partnership. The
update can be advanced if a need is expressed by the OHAMR partners. The update will be basedon the KPI assessment, on the recommendations formulated by the OHAMR Scientific Advisory
Board and by OHAMR stakeholders. During the process, consultation (s) opened to academic
researchers, SME/ Industry, end-users, country-representatives and stakeholders will take place.

OHAMR Strategic Research and Innovation Agenda

62.

Annex 2. Detailed list of topics andsubtopics covered by the three focus
areas
Focus Area 1: Prevent emergence and spread of AMR•

Identification and characterisation of the factors (molecular, behavioural, ecological, social,societal, economic and environmental70) and mechanisms driving the emergence, evolution,
selection and maintenance of the resistance genes and resistant microorganisms◦ Including: Identification of new hot-spots and the factors determining an outbreak from
AMR hotspots in different OH sectors; effect of different drugs and drug formulations,effect of disinfectants, effect of climate change, pollution, war, conflicts and migration
on AMR emergence; utilisation of, and development of new, innovative tools to study
AMR emergence, evolution, selection and maintenance (such as new generation
sequencing, metagenomic data-sets machine learning, modelling); identification of new
targets for antimicrobials.

•

Identification and characterisation of the risks, drivers, scale and direction of the AMR
transmission routes within and between the different OH sectors◦ Including: Development of new tools for the harmonisation and integration of surveillancedata from different OH sectors and countries, models to simulate AMR transmission,
artificial intelligence (AI) tools, and risk assessment models; identification of AMR
reservoirs and hotspots at different levels of granularity as well as of determinants ofsuccessful transmission; identification of knowledge gaps regarding AMR transmission,
including antiparasitic and antiviral resistance.

•

Development of innovative solutions to limit the discharge, persistence, accumulation of
antimicrobials and resistant genes/micro-organisms in the environment◦ Including: Development of novel solutions to limit AMR in AMR hotspots, novel
decontamination strategies and strategies to limit discharge into the environment fromall OH sectors; Design of degradable drug scaffolds and de-risking strategies for therecycling of organic waste in agricultural systems.

A broad definition of environment is used throughout the document, including social and physical environment, in vivo environment (e.g.
microbiota) and wildlife.

70

OHAMR Strategic Research and Innovation Agenda

63.

•

Comparison of existing interventions aiming to limit AMR emergence and spread, andevaluation of their impact on AMR and their social, societal and economic benefit◦ Including: Comparison of existing Interventions aiming to limit discharge of AMs and
AMR determinants into the environment and to limit transmission between OH sectors;
comparison of existing communication strategies directed to the general public, decisionmakers and different stakeholders in all OH sectors to increase awareness and on AMR
transmission risk.

•

Development of solutions to improve the access to social and technological innovations andinterventions aiming to reduce AMR emergence and spread, and to facilitate their availability
and their uptake by end-users.
◦ Including: Identification of barriers of access and uptake; Adaptation to different OH andsocio-economic settings

Focus area 2: Strengthen appropriate use of antimicrobials and infection
prevention and control•

Identification and characterisation of the factors leading to an appropriate or excessive use of
antimicrobials◦ Including: Social, societal, cultural, systemic, economic and behavioural factors that
affects antimicrobial use (AMU) and infection prevention and control (IPC) strategies.

•

Design and develop social and technical innovations, including diagnostics, aiming to facilitate
the appropriate use of antimicrobials◦ Including: Design of easy to use and rapid diagnostic tools to support decision onwhether to use antimicrobial or not, and which antimicrobial to use; Improvement of
AMR and AMU surveillance to guide antimicrobial empiric prescription; design of tools(e.g. AI tools) to guide antimicrobial prescription; optimisation of treatment protocols toimprove antimicrobial use, such as treatment duration, personalised dosing, switch tonarrow-spectrum antimicrobials71; Development of communication strategies tailored to
stakeholders, decision-makers and end-users to promote reduced antimicrobial use andprescription.

•

Design of social and technical innovations aiming to prevent or reduce the incidence of
infections◦ Including: development of solutions to decrease the risk of infection and thereby theneed for antimicrobials, such as novel or improved IPC strategies, novel or improved
water, sanitation and hygiene (WASH) strategies, anti-adherent surfaces, or probiotics;

71

Please note that other therapeutic strategies are included in the focus area 3 ” Provide innovative and cost-effective treatment options “.

OHAMR Strategic Research and Innovation Agenda

64.

identification of vaccination targets; stewardship interventions in human health andagriculture and measures to improve food safety; Development of communication
strategies tailored to stakeholders, decision-makers and end-users to promote infection
prevention and control, and water, sanitation and hygiene.
•

Comparison of existing interventions aiming to reduce antimicrobial use or prevent infectious
diseases in humans, animals, and plants and evaluation of their impact on human health, aswell as their social, societal and economic benefit◦ Including: Studies demonstrating the cost-effectiveness of the use of diagnostic
tools, vaccination and sanitation campaigns and infection and control measures, newreimbursement models, new regulations for antimicrobial prescription, new societalorganisation.

•

Identification of barriers to uptake of and access to social, societal and technologicalinnovations aiming to improve antimicrobial use and prevention of infection in humans,
animals, and plants, and development of solutions to overcome these barriers◦ Including: Uptake of diagnostics and surveillance, as well as interventions aiming toprevent infections (including vaccination); Implementation studies in different socioeconomic settings; Proposals of new reimbursement models and new guidelines/
regulations for antimicrobial prescription, new societal organisation.

Focus area 3: Provide innovative and cost-effective treatment options•

To develop new antimicrobials, novel treatment protocols or alternative treatment therapies
against Human Infectious diseases along with their respective diagnostics◦ Including: development of new antimicrobials (new scaffolds, narrow spectrum
antimicrobials, against new drug targets, repurposed molecules …) and alternative
treatments, as well as their associated diagnostics for human infectious diseases;
identification of current therapeutic gaps to treat infections resistant to antifungal,
antiviral and antiparasitic treatments including needs in LMICs.

•

To improve, preserve and reinforce the clinical efficacy of the current treatment antimicrobials◦ Including: Improved drug composition, formulation and drug delivery methods as well as
treatment protocols (including personalised medicine, combination therapies) to increase
antimicrobial efficacy and decrease the probability of resistance development; strategies
to recycle antimicrobials that are not suitable for human use for animal/plant use; costeffectiveness studies of existing and novel treatment protocols.

OHAMR Strategic Research and Innovation Agenda

65.

•

Identification of barriers to access, availability, quality and uptake of therapeutic solutions anddevelopment of solutions to overcome those barriers◦ Including: Barriers to uptake alternative treatments (including current regulations);
access and availability in low-resource settings; adherence to therapeutic and diagnostic
protocols; availability of suitable prescribers, supply chains; healthcare organisation,
financing and insurance and agricultural system organisation.

•

Assessment and prediction of the impact of economic incentives and regulations on drug
development, drug production, drug supply and treatment availability◦ Including: economic analysis, strategic foresight and modelling/forecasting, side-effects ofeconomic models; effect on AMR burden.

OHAMR Strategic Research and Innovation Agenda

66.

Abbreviations
AI		
Artificial Intelligence
AMC		
Antimicrobial consumption
AMR		
Antimicrobial Resistance
AMU		
Antimicrobial Use
CSA		
Coordination and Support ActionEC		European Commission
ECDC		
European Centre for Disease Prevention and Control
ECR		
Early Career Researcher
EEA		
European Environment Agency
EFSA		
European Food Safety Authority
EMA		
European Medicines Agency
ERA		
European Research Area
ERA4Health
ERA for Health ResearchEU		European Union
EUP AH&W
European Partnership on Animal Health and Welfare
FAIR		
Findable, Accessible, Interoperable and Reusable
FAO		
Food and Agriculture Organisation of the United NationsGDP		
Gross domestic product
GH EDCTP3 JU Global Health European & Developing Countries Clinical Trials Partnership Joint		
Undertaking
GO		
General objective
HERA		
Health Emergency Preparedness and Response Department
IACG		
Interagency Coordination Group on Antimicrobial Resistance
JAMRAI		
Joint Action on Antimicrobial Resistance
JPIAMR		
Joint Programming Initiative on AMR
JTC		
Joint transnational call
KPI		Key Performance Indicators
LMIC		
Low- and middle-income country
Non-governmental organisations
NGO		
OH		
One Health
OHAMR		One Health AMR
One Health EJP One Health European Joint Programming
OO		
Operational objective
R&I		
Research and innovation
SDG		
Sustainable Development Goal

OHAMR Strategic Research and Innovation Agenda

67.

SME		SRIA		SO		UN		UNEP		WHO		WOAH		

Small and medium-sized enterprise
Strategic Research and Innovation Agenda
Specific objective
United Nations
UN Environment Programme
World Health Organization
World Organisation for Animal Health

OHAMR Strategic Research and Innovation Agenda

68.

OHAMR Secretariat
Swedish Research Council
Box 1035
SE-101 38 Stockholm
OHAMR Strategic Research and Innovation Agenda

www.ohamr.eu
ohamr@vr.se+46 8 546 44 00070.